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MINERVA CARDIOANGIOLOGICA

A Journal on Heart and Vascular Diseases


Official Journal of the Italian Society of Angiology and Vascular Pathology
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Minerva Cardioangiologica 2008 February;56(1):67-77

language: English

Intravascular ultrasound guidance in drug-eluting stent deployment

Roy P., Waksman R.

Division of Cardiology Washington Hospital Center, Washington, DC, USA


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The role of routine intravascular ultrasound (IVUS) guidance during percutaneous coronary intervention (PCI) in the bare metal stent era remains controversial. The potential to reduce revascularization was reported without impacting non-fatal myocardial infarction and death. Drug-eluting stents (DES) have realized improved clinical results in patients undergoing PCI but are not free of restenosis and are limited by thrombosis, particularly in more complex lesion types. Stent under-expansion, malapposition, and incomplete lesion coverage have been identified as the key mechanisms of DES failure. The identification of these features on IVUS and their subsequent treatment may lead to improved clinical outcomes. Though a clinical benefit is intuitive, results from randomized trials are still needed to justify routine IVUS guided DES implantation. The Authors provide a review of the currently available evidence pertaining to the potential clinical benefit of IVUS guidance in DES implantation.

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